Ren Hua, Wang Lü-hua, Wang Xiao-zhen, Lü Ji-ma, Ji Wei, Zhou Zong-mei, Ou Guang-fei, Yin Wei-bo
Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2009 Feb;31(2):143-7.
To retrospectively analyze the effects of different chemotherapy regimens for concurrent chemoradiation on locally advanced non-small cell lung cancer (NSCLC).
The data from 106 patients diagnosed as locally advanced NSCLC (IIIa: 29, IIIb: 77), who received various chemotherapy regimens for concurrent chemoradiotherapy, were retrospectively analyzed. Paclitaxel-based chemotherapy regimen was administered in 55 patients, topotecan regimen in 21 patients, PE (cisplatin and etopside) regimen in 26 patients, and other regimens in the remaining 4 patients. The effect of different chemotherapy regimens on overall survival and toxicity was analyzed.
The median survival time was 18.6 months, and the overall 1- and 3-year survival rates were 72.2% and 27.5%, respectively. The median survival time of 102 patients treated with paclitaxel-containing, topotecan-containing or PE regimens was 16.3, 27.3 and 29.1 months, respectively. The overall survival times of topotecan and PE groups were superior to that of paclitaxol-based group, but not significantly different (P = 0.32). Both univariate and multivariate analysis showed that paclitaxol-based chemotherapy regimen was significantly associated with a poorer survival (P < 0.05). N stage was another significant prognostic factor determined by COX multivariate regression model. Compared with the other regimens (10.6%), paclitaxel-based regimen (27.3%) had more acute radiation pneumonitis (grade >or= 2, P = 0.03), but no significant differences were observed in blood toxicity and esophagitis.
There is a correlation between different chemotherapy regimens for concurrent chemoradiotherapy and the overall survival and acute radiation pneumonitis in patients with locally advanced NSCLC.
回顾性分析不同化疗方案同步放化疗对局部晚期非小细胞肺癌(NSCLC)的疗效。
回顾性分析106例诊断为局部晚期NSCLC(Ⅲa期:29例,Ⅲb期:77例)且接受多种同步放化疗化疗方案的患者数据。55例患者采用以紫杉醇为主的化疗方案,21例患者采用拓扑替康方案,26例患者采用PE(顺铂和依托泊苷)方案,其余4例患者采用其他方案。分析不同化疗方案对总生存期和毒性的影响。
中位生存时间为18.6个月,1年和3年总生存率分别为72.2%和27.5%。接受含紫杉醇、含拓扑替康或PE方案治疗的102例患者的中位生存时间分别为16.3、27.3和29.1个月。拓扑替康组和PE组的总生存时间优于以紫杉醇为主的组,但差异无统计学意义(P = 0.32)。单因素和多因素分析均显示,以紫杉醇为主的化疗方案与较差的生存率显著相关(P < 0.05)。N分期是COX多因素回归模型确定的另一个重要预后因素。与其他方案(10.6%)相比,以紫杉醇为主的方案(27.3%)发生急性放射性肺炎(≥2级,P = 0.03)的情况更多,但在血液毒性和食管炎方面未观察到显著差异。
局部晚期NSCLC患者同步放化疗的不同化疗方案与总生存期和急性放射性肺炎之间存在相关性。